Clinical Research in Cardiology

, Volume 96, Issue 3, pp 152–159 | Cite as

Effect of stress-induced reversible ischemia on serum concentrations of ischemia-modified albumin, natriuretic peptides and placental growth factor

  • Kerstin KurzEmail author
  • Ralf Voelker
  • Dietmar Zdunek
  • Ragnhild Wergeland
  • Georg Hess
  • Boris Ivandic
  • Hugo Katus
  • Evangelos Giannitsis



There is controversy whether new biomarkers are able to identify myocardial ischemia in the absence of myonecrosis.


We measured NT-pro BNP, NT-pro ANP, ischemia-modified albumin (IMA) and placental growth factor (PlGF) in patients undergoing nuclear stress testing for suspected ischemic heart disease. A thallium scan was used for detection of reversible myocardial ischemia and cardiac troponin T (cTnT) for exclusion of stress-induced myonecrosis. Of 195 patients, 24 with reversible and 62 with no perfusion defect were included in the analysis. Plasma levels were measured before, 18 min and 4 h after stress testing.


Of the 86 patients, 52 received an exercise stress and 34 dipyridamol. New myonecrosis indicated by cTnT could be excluded in all patients. Plasma levels of NT-pro BNP and NT-pro ANP before testing were significantly higher in patients who later developed reversible perfusion defects (NT-pro BNP 139.00 (58.25/367.01) pg/mL vs 327.45 (120.50/972.85) pg/mL, p < 0.05; NT-pro ANP 732.5 (470.0/ 1220.0) pg/mL vs 1470.0 (694.0/ 1910.0) pg/mL, p < 0.05). Plasma levels of NT-pro BNP, NT-pro ANP and PIGF did not change significantly after stress testing, IMA levels rose significantly after 4 h in patients with and without reversible perfusion defects.


The elevation of NTpro BNP and NT-pro ANP at baseline may represent the cumulative effect of repeated bouts of myocardial ischemia. A single brief episode of provoced ischemia does not cause a significant increase of the measured biomarkers beside from IMA after exercise stress test potentially indicating skeletal muscle ischemia.

Key words

Myocardial ischemia biochemical markers troponin 


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Copyright information

© Steinkopff-Verlag 2006

Authors and Affiliations

  • Kerstin Kurz
    • 1
    Email author
  • Ralf Voelker
    • 1
  • Dietmar Zdunek
    • 2
  • Ragnhild Wergeland
    • 3
  • Georg Hess
    • 2
  • Boris Ivandic
    • 1
  • Hugo Katus
    • 1
  • Evangelos Giannitsis
    • 1
  1. 1.Abteilung Innere Medizin III, Medizinische KlinikUniversitätsklinikum HeidelbergHeidelbergGermany
  2. 2.Roche Diagnostics GmbHMannheimGermany
  3. 3.Institute of Clinical ChemistryRikshospitaletOsloNorway

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